Educating caregivers to recognise the clinical signs of pneumonia in children younger than 6 months

Background. Pneumonia remains the foremost cause of death in young children in sub-Saharan Africa. This phenomenon is largely driven by poor access to healthcare and delay in seeking medical care for childhood pneumonia. Objective. To assess the effectiveness of training caregivers to recognise the early clinical signs of pneumonia. Methods. The study involved a cohort of women presenting to the Child Welfare Clinic at the Komfo Anokye Teaching Hospital in Kumasi, Ghana, between 7 July and 8 September 2016. A total of 90 women with children younger than 10 weeks were recruited. Participants were trained on identifying early signs of pneumonia using low-cost equipment. Follow-up training and assessment sessions formed part of the programme.Results. At pre-training assessment, the majority of the participants (n=83/90; 92.2%) recognised lower chest indrawing as a sign of respiratory disease requiring immediate hospital intervention. Participants' performance in determining rhythms of 50 breaths per minute (bpm) and 60 bpm improved significantly across sessions (p=0.011 and p≤0.001, respectively). After training, 87 participants (96.7%) were able to determine rapid breathing accurately compared with 73 participants (81.1%) before training (p=0.001).Conclusion. The results suggest that caregivers can be effectively trained to identify clinical signs of pneumonia in young children, even in low-resource settings. A training initiative as described in this study could be an effective public health intervention to help address the burden of pneumonia in low-resource settings

Sports injuries in second-cycle institutions: the burden on, and risk factors associated with student health

Introduction: Adolescent engagement in sport and other recreational activities has been increasingly embraced worldwide due to its benefits. Notwithstanding, it also remains one of the major contributors to injury burden translating into half of the global injury rate. Yet not much is known about the prevalence of sports-related injuries and the associated risk factors among second-cycle institution athletes in Ghana. This study sought to estimate prevalence and identify the risk factors associated with sport injuries among athletes in Second-cycle institutions in the Kumasi Metropolitan area. Method: A cross-sectional design was carried out with 600 athletes from 16 out of the 24 public schools in the Kumasi metropolis through a two-stage cluster sampling. A smartphone interviewer-administered questionnaire was used to collect data from the athletes. Data were summarized in tables and figures. Bivariate and multivariate logistic regression were performed to identify independent predictors of injury. Data were analyzed with STATA version 14.0. Result: The overall injury prevalence estimated was thirty-eight percent. Dislocations and sprains (46.7%) and closed wounds (1.5%) were the common and least injury types recorded. Likewise, ankle and elbow were the most and least body region to be affected respectively. Individual factors such as nature of sports and years of playing experience were the identified predictors of adolescent injuries. Conclusion: Adolescent sports injury prevalence is high in Kumasi metropolis among second-cycle institution. Dislocation and sprains were the most common injuries. These were mostly associated with contact sports

Epidemiology of paediatric poisoning reporting to a tertiary hospital in Ghana

Background. Childhood poisoning is an important cause of morbidity in both developed and developing countries. Epidemiological studies on accidental poisoning in children show a consistent pattern regarding age and gender. Childhood poisoning is predominant in children 6 years of age and has a male preponderance; as boys are more active with a drive to explore the environment. Objective. To document the epidemiology of home poisonings in Kumasi and its environs. Methods. We conducted a retrospective study from January 2007 to January 2012 at the Komfo Anokye Teaching Hospital; a tertiary hospital in Ghana.Results. Poisoning is a significant health problem in the study area. A total of 253 children reported to the hospital with poisoning over the 61-month period; with an average of four cases per month. The male to female ratio was 1.58:1. The median age of the children was 24 months (interquartile range 24 - 48 months). Kerosene was the leading cause of poisoning (39.5%). Conclusion. Paediatric poisoning is a major health hazard in children living in Kumasi and its environs. This can possibly be attributed to a lack of adequate supervision of children and poor storage of harmful substances in homes. Multidisciplinary interventions are needed to reduce the occurrence of the condition in the population at risk

Verbal Autopsy: an Analysis of the Common Causes of Childhood Death in the Barekese Sub-District of Ghana

The availability of mortality data for any society plays an essential role in health monitoring and evaluation; as well as in the design of health interventions. However; most resource-poor countries such as Ghana have no reliable vital registration system. In these instances; verbal autopsy (VA) may be used as an alternative method to gather mortality data. In rural Ghana; the research team utilized a VA questionnaire to interview caretakers who were present with a child under the age of five prior to death. The data was given to two physicians who independently assigned the most probable cause of death for the child. A third; blinded physician analyzed the data in the cases where the first two physicians disagreed. When there was agreement between physicians; this was assigned as the cause of death for the individual child. During the study period; we recorded 118 deaths from 92 households. Twenty-nine (24.6) were neonatal deaths with the leading causes of death being neonatal sepsis; birth asphyxia and pneumonia. The remaining 89 (75.4) were post-neonatal deaths with the most common causes of death being pneumonia; malaria and malnutrition. While 63/118 (53.4) deaths occurred in the home; there is no statistically significant relationship between the location of the home and the time of travel to the nearest health facility (P=0.132). VA is an important epidemiological tool for obtaining mortality data in communities that lack reliable vital registration systems. Improvement in health care is necessary to address the large number of deaths occurring in the home

Adherence to Antiretroviral Therapy; Virologic Failure and Workload at the Rustenburg Provincial Hospital

Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remainsthe most important potentially alterable factor that determines treatment outcomes.Methods: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included arandomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results. Results: Only 71of patients had an adherence 95. Poor adherence was related to changes in daily routines (being away from home [21] and busy with other things [17]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7) had virologic failure than did employed patients (40) (p = 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio; and the proportion of patients lost to follow-up doubled in the preceding four years. Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered

Adherence to Antiretroviral Therapy; Virologic Failure and Workload at the Rustenburg Provincial Hospital

Background: Adherence to antiretroviral therapy (ART) is a strong predictor of progression to AIDS and death. It remains the most important potentially alterable factor that determines treatment outcomes. Methods: The study is a cross-sectional survey of self-reported adherence to ART and associated factors. It included a randomly selected sample of 100 adult patients who began ART between June 2006 and December 2007. A modified Adult AIDS Clinical Trials Group questionnaire was used. The analysis compared self-reported adherence levels by factor and viral load test results. Results: Only 71of patients had an adherence 95. Poor adherence was related to changes in daily routines (being away from home [21] and busy with other things [17]). All patients with symptoms suggestive of clinical depression had virologic failure. More unemployed patients (50.7) had virologic failure than did employed patients (40) (p = 0.05). The clinic had a tenfold increase in patient enrolment and a ninefold decline in staff-to-patient ratio; and the proportion of patients lost to follow-up doubled in the preceding four years. Conclusion: Adherence to ART was poor. The capacity of the clinic to manage patients adequately has declined significantly. Decentralisation of ART services to primary health care facilities should be considered